This is a competitive renewal application for a NRSA grant T32 HD4435 which was first funded in 6/01/2003. The goal of the Institutional NRSA at Johns Hopkins University is to train pediatric residents and fellows to become successful junior faculty whose primary) research interest is in the diagnosis, pathogenesis and treatment of genetic and acquired disorders in children. To date we have funded 13 trainees, (6 women and 7 men; two under represented minority trainees, and trainees in Pediatric Hematology/Oncology, Neurology, Cardiology, Gastroenterology, Nephrology, Neonatology and Adolescent Medicine. Five of our trainees have now completed their training and have joined our faculty. The program recruits and trains individuals to use the most modern techniques in genetics, genomics, molecular biology and the principles of clinical research to address, pathogenesis, diagnoses, and therapy for pediatric disease. In 2006 the Pediatric residency program was awarded continued accreditation by the Residency Review Committee for Pediatrics of the ACGME. The residency program continues to attract approximately 25 M.D. /PhD. candidates per year during the intern matching process and in the past 5 years 4 residents have completed the Integrated Research Pathway. Over the last 5 years over half of our residents have entered subspecialty training. 18% of the present residents, 18 % of the 15 subspecialty fellows and 8% of the full time faculty are members of underrepresented minorities. The Department of Pediatrics presently has 28 million dollars in NIH research dollars which does NOT include >15 million dollars presently funded in Pediatric Oncology, Pediatric Genetics, Pediatric Neurology and Pediatric Developmental Biology (all these divisions are located outside of the Department of Pediatrics). It is our goal to use the NRSA funds to continue to recruit a diverse group of residents and fellows who wish to become clinician scientists, to provide them mentorship from both basic science and clinical departments, to insure that they have access to formal training in all aspects of basic and clinical research, and to provide an academic environment which will insure that they will become independent, productive pediatric clinician scientists. We have in place a plan for tracking our trainees and measuring their success through publications, grant funding and future academic appointments.